Increased Risk of Hyperglycemia in Advanced Urothelial Cancer Patients Treated with Enfortumab Vedotin: A Systematic Review and Meta-Analysis.

IF 1.8 4区医学 Q3 ONCOLOGY

Cancer Investigation Pub Date : 2025-05-01 Epub Date: 2025-05-13 DOI:10.1080/07357907.2025.2502992

Ryan Cheng, Montek Boparai, Xiaolei Zhu, Shenhong Wu

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引用次数: 0

Abstract

Background: Enfortumab vedotin, an anti-nectin-4 antibody-drug conjugate, is a key treatment for advanced urothelial cancer. However, hyperglycemia, a major adverse event, varies in incidence and can progress to diabetic ketoacidosis. We conducted a systematic review and meta-analysis to quantify the risk of hyperglycemia with enfortumab vedotin.

Material and methods: We searched studies published through September 30, 2024. Eligible clinical trials evaluated enfortumab vedotin as a monotherapy or combined with pembrolizumab. Pooled incidence and relative risk of hyperglycemia were calculated using random- or fixed-effects models.

Results: Seven studies with 2,138 patients were included in our analysis. The summary incidence of all-grade hyperglycemia was 10.3% (95% CI: 8.6-12.2%), and high-grade hyperglycemia occurred in 5.7% (95% CI: 4.5-7.1%) of patients. No significant difference was observed between monotherapy and combination therapy (p = 0.16). Enfortumab vedotin significantly increased the risk of all-grade (RR = 16.97, 95% CI: 6.22-48.25, p < 0.001) and high-grade hyperglycemia (RR = 34.78, 95% CI: 4.77-253.43, p < 0.001).

Conclusion: Enfortumab vedotin is associated with a significantly increased risk of all-grade and high-grade hyperglycemia in urothelial cancer. Its combination with pembrolizumab does not appear to elevate this risk further. Routine glucose monitoring and early intervention should be implemented, particularly in high-risk patients.

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晚期尿路上皮癌患者接受维多汀治疗时高血糖风险增加：一项系统回顾和荟萃分析

背景：Enfortumab vedotin是一种抗nectin-4抗体-药物偶联物，是治疗晚期尿路上皮癌的关键药物。然而，高血糖，一个主要的不良事件，发病率不同，并可发展为糖尿病酮症酸中毒。我们进行了一项系统回顾和荟萃分析，以量化使用维多汀引起高血糖的风险。材料和方法：我们检索了截至2024年9月30日发表的研究。合格的临床试验评估了enfortumab vedotin作为单药治疗或与pembrolizumab联合使用。采用随机或固定效应模型计算高血糖的合并发病率和相对危险度。结果：7项研究，2138例患者纳入我们的分析。所有级别高血糖的总发生率为10.3% (95% CI: 8.6-12.2%)，高血糖发生率为5.7% （95% CI: 4.5-7.1%）。单药治疗与联合治疗无显著差异（p = 0.16）。恩托单抗vedotin显著增加了尿路上皮癌发生所有级别高血糖的风险（RR = 16.97, 95% CI: 6.22-48.25, p）。结论：恩托单抗vedotin与尿路上皮癌发生所有级别和高度高血糖的风险显著增加相关。它与派姆单抗联合使用似乎不会进一步提高这种风险。应实施常规血糖监测和早期干预，特别是对高危患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Investigation 医学-肿瘤学

CiteScore

3.80

自引率

4.20%

发文量

审稿时长

8.5 months

期刊介绍： Cancer Investigation is one of the most highly regarded and recognized journals in the field of basic and clinical oncology. It is designed to give physicians a comprehensive resource on the current state of progress in the cancer field as well as a broad background of reliable information necessary for effective decision making. In addition to presenting original papers of fundamental significance, it also publishes reviews, essays, specialized presentations of controversies, considerations of new technologies and their applications to specific laboratory problems, discussions of public issues, miniseries on major topics, new and experimental drugs and therapies, and an innovative letters to the editor section. One of the unique features of the journal is its departmentalized editorial sections reporting on more than 30 subject categories covering the broad spectrum of specialized areas that together comprise the field of oncology. Edited by leading physicians and research scientists, these sections make Cancer Investigation the prime resource for clinicians seeking to make sense of the sometimes-overwhelming amount of information available throughout the field. In addition to its peer-reviewed clinical research, the journal also features translational studies that bridge the gap between the laboratory and the clinic.